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Universal School Meal Policies and Perceived Stigma: Quantitative Evidence from Eight US States

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Title: Universal School Meal Policies and Perceived Stigma: Quantitative Evidence from Eight US States
Language: English
Authors: Dania Orta-Aleman (ORCID 0000-0001-8581-8714), Monica D. Zuercher (ORCID 0000-0003-2758-9807), Leah E. Chapman, Marlene B. Schwartz (ORCID 0000-0002-8939-1954), Caitlin D. French, Anisha I. Patel, Lorrene Ritchie (ORCID 0000-0002-8038-1821), Juliana Cohen, Wendi Gosliner
Source: Journal of School Health. 2026 96(1).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 9
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Education Level: Junior High Schools
Middle Schools
Secondary Education
High Schools
Descriptors: Lunch Programs, Social Bias, Nutrition, Middle School Students, High School Students, Psychological Patterns, Low Income Students, Socioeconomic Status, Student Attitudes, Parent Attitudes, Educational Policy, Intervention, Student Characteristics
Geographic Terms: California, Maine, Massachusetts, Vermont, Arizona, Texas, Illinois, New Hampshire
DOI: 10.1111/josh.70098
ISSN: 0022-4391
1746-1561
Abstract: Background: Universal school meals (USMs) policies, which provide free meals to all students regardless of income, have the potential to improve child nutrition and reduce stigma. Quantitative evidence on the association between USM and stigma is limited. Methods: Leveraging a natural policy variation in state-level USM implementation, we surveyed 1066 middle and high school students from eight US states (four with USM, four without) during the 2022-2023 school year. Stigma was measured as self-reported embarrassment about eating school lunch. We used generalized estimating equations to examine the associations between USM, embarrassment, and lunch participation. Results: Overall about one in nine students (11.5%) across all surveyed states reported embarrassment, which was associated with 11% less frequent (aRR = 0.89, 95% CI: 0.83-0.97). School lunch participation overall, especially among those from low-income families. While USM was associated with lower odds of embarrassment among students from low-income families, higher-income students in USM states were more likely to feel embarrassed. Implications: Addressing stigma requires pairing USM with strategies to enhance meal quality, cultural relevance, and inclusive messaging. Conclusions: USM can alleviate stigma for lower-income students yet may increase embarrassment among higher-income peers, highlighting the need for comprehensive approaches benefiting all socioeconomic groups.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1492064
Database: ERIC
FullText Text:
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  Data: Universal School Meal Policies and Perceived Stigma: Quantitative Evidence from Eight US States
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  Data: <searchLink fieldCode="AR" term="%22Dania+Orta-Aleman%22">Dania Orta-Aleman</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-8581-8714">0000-0001-8581-8714</externalLink>)<br /><searchLink fieldCode="AR" term="%22Monica+D%2E+Zuercher%22">Monica D. Zuercher</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-2758-9807">0000-0003-2758-9807</externalLink>)<br /><searchLink fieldCode="AR" term="%22Leah+E%2E+Chapman%22">Leah E. Chapman</searchLink><br /><searchLink fieldCode="AR" term="%22Marlene+B%2E+Schwartz%22">Marlene B. Schwartz</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-8939-1954">0000-0002-8939-1954</externalLink>)<br /><searchLink fieldCode="AR" term="%22Caitlin+D%2E+French%22">Caitlin D. French</searchLink><br /><searchLink fieldCode="AR" term="%22Anisha+I%2E+Patel%22">Anisha I. Patel</searchLink><br /><searchLink fieldCode="AR" term="%22Lorrene+Ritchie%22">Lorrene Ritchie</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-8038-1821">0000-0002-8038-1821</externalLink>)<br /><searchLink fieldCode="AR" term="%22Juliana+Cohen%22">Juliana Cohen</searchLink><br /><searchLink fieldCode="AR" term="%22Wendi+Gosliner%22">Wendi Gosliner</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+School+Health%22"><i>Journal of School Health</i></searchLink>. 2026 96(1).
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: Y
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  Label: Page Count
  Group: Src
  Data: 9
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  Label: Publication Date
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  Data: 2026
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  Data: Journal Articles<br />Reports - Research
– Name: Audience
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  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Junior+High+Schools%22">Junior High Schools</searchLink><br /><searchLink fieldCode="EL" term="%22Middle+Schools%22">Middle Schools</searchLink><br /><searchLink fieldCode="EL" term="%22Secondary+Education%22">Secondary Education</searchLink><br /><searchLink fieldCode="EL" term="%22High+Schools%22">High Schools</searchLink>
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  Label: Descriptors
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  Data: <searchLink fieldCode="DE" term="%22Lunch+Programs%22">Lunch Programs</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Bias%22">Social Bias</searchLink><br /><searchLink fieldCode="DE" term="%22Nutrition%22">Nutrition</searchLink><br /><searchLink fieldCode="DE" term="%22Middle+School+Students%22">Middle School Students</searchLink><br /><searchLink fieldCode="DE" term="%22High+School+Students%22">High School Students</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+Patterns%22">Psychological Patterns</searchLink><br /><searchLink fieldCode="DE" term="%22Low+Income+Students%22">Low Income Students</searchLink><br /><searchLink fieldCode="DE" term="%22Socioeconomic+Status%22">Socioeconomic Status</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Attitudes%22">Parent Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Policy%22">Educational Policy</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Characteristics%22">Student Characteristics</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22California%22">California</searchLink><br /><searchLink fieldCode="DE" term="%22Maine%22">Maine</searchLink><br /><searchLink fieldCode="DE" term="%22Massachusetts%22">Massachusetts</searchLink><br /><searchLink fieldCode="DE" term="%22Vermont%22">Vermont</searchLink><br /><searchLink fieldCode="DE" term="%22Arizona%22">Arizona</searchLink><br /><searchLink fieldCode="DE" term="%22Texas%22">Texas</searchLink><br /><searchLink fieldCode="DE" term="%22Illinois%22">Illinois</searchLink><br /><searchLink fieldCode="DE" term="%22New+Hampshire%22">New Hampshire</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/josh.70098
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0022-4391<br />1746-1561
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Universal school meals (USMs) policies, which provide free meals to all students regardless of income, have the potential to improve child nutrition and reduce stigma. Quantitative evidence on the association between USM and stigma is limited. Methods: Leveraging a natural policy variation in state-level USM implementation, we surveyed 1066 middle and high school students from eight US states (four with USM, four without) during the 2022-2023 school year. Stigma was measured as self-reported embarrassment about eating school lunch. We used generalized estimating equations to examine the associations between USM, embarrassment, and lunch participation. Results: Overall about one in nine students (11.5%) across all surveyed states reported embarrassment, which was associated with 11% less frequent (aRR = 0.89, 95% CI: 0.83-0.97). School lunch participation overall, especially among those from low-income families. While USM was associated with lower odds of embarrassment among students from low-income families, higher-income students in USM states were more likely to feel embarrassed. Implications: Addressing stigma requires pairing USM with strategies to enhance meal quality, cultural relevance, and inclusive messaging. Conclusions: USM can alleviate stigma for lower-income students yet may increase embarrassment among higher-income peers, highlighting the need for comprehensive approaches benefiting all socioeconomic groups.
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  Data: 2026
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      – Text: English
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      – SubjectFull: Lunch Programs
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      – SubjectFull: Social Bias
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      – SubjectFull: Nutrition
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      – SubjectFull: Middle School Students
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